All humans-no matter how intelligent, egalitarian, or well-intentioned-are susceptible to cognitive biases in the way they make decisions and judge others. Although these biases can operate unintentionally in opposition to one's conscious intentions, personal beliefs, and objective data, they may unwittingly perpetuate social inequalities. Unexplained disparities in R01 funding outcomes by race and gender have raised concern about bias in NIH peer review. This Transformative R01 will examine if and how implicit (i.e., unintentional) bias might occur in R01 peer review through the following three Specific Aims: Specific Aim #1. Identify the extent to which investigator characteristics influence the words and descriptors chosen by R01 peer-reviewers and how text relates to assigned scores. We will validate positive and negative grant evaluation word categories, analyze the text of a national sample of R01 reviews, and compare the grant review text for different investigator characteristics. We hypothesize that categories of words and descriptors will differ in ways that suggest implicitly different evaluation standards by applicant race and gender, even when application scores and funding outcomes are similar. Specific Aim #2. Determine whether investigator race, gender, or institution causally influences the review of identical proposals. We will conduct a randomized, controlled study in which we manipulate characteristics of a grant principal investigator (PI) to assess their influence on grant review outcomes. We will request donations of actual funded R01s and, within each grant, manipulate the PI's gender, race, or home institution. We will then invite reviewers in the appropriate discipline to review the proposals, and we will analyze written reviews and scores. We hypothesize that investigator variables will significantly influence scores and review text such that grants attributed to higher status groups (male, White, prestigious institution) will obtain better scores and text will suppor implicitly different standards of excellence. Specific Aim #3. Examine how interactional patterns among study section members promote receptivity and resistance to discussion topics and associated grant applicants. In audio- and videotapes of constructed study sections, we will investigate the real-time social interactional processes in the discussions of R01 proposals. We will employ conversation analysis to examine the delivery of initial rankings and their rationales, topic development, and the processes through which final rankings are negotiated. This research is innovative because it examines for the first time the complexities of potential bias in NIH peer review. The potential impact is threefold; this research will 1) discover whether certain forms of cognitive bias are or are not consequential in R01 peer review, 2) determine whether quantitative text analysis is a useful measure of implicit bias, and 3) describe and label real-tim grant reviewer interactional patterns. Taken together, the results of our research could set the stage for transformation in peer review throughout NIH.